Introduction

Night eating syndrome (NES) is a type of eating disorder, which means there are irregular eating habits.¹ This might include:

• Eating too much or too little
• Spending lots of time thinking about your eating 
• Having strict habits/routines around food 
• Feelings of guilt about eating 
• Weight fluctuations 

Night eating syndrome is characterised by eating a large amount of food in the evening or eating after waking up from a nighttime sleep. You must also have at least three symptoms from this list:¹

• Morning anorexia (not eating in the morning)
• Urge to eat after dinner/before sleep
• Urge to eat during the night 
• Insomnia (either trouble falling asleep or staying asleep)
• Low mood in the evening 
• Believing you cannot sleep without eating 

For diagnosis, you must be aware of the symptoms, which must also cause significant suffering or distress. While not everyone will be overweight, it is more frequently found in people who are. Symptoms typically begin in the late teens to late twenties.

Symptoms must be recognised to seek help and treatment. If you are experiencing any of the above, please seek medical advice.

Key signs 

Eating pattern disruptions

There are two types of night eating disorder: eating lots at night, or waking through the night to eat, each of which with different symptoms.

Excessive eating at night (often after dinner)

Eating lots of food at night includes bingeing, which is less likely to occur in those who wake up during the night. The most severe binge eating may happen in this group, and obesity may be more common. 

Insomnia or frequent waking during the night with the urge to eat

In this case, those with night eating disorders might struggle to sleep at night, and may often wake up throughout the night and feel the urge to eat. This may be an uncontrollable urge, and they may not be able to go back to sleep until they have eaten.

Low appetite in the morning

In night eating disorders, people often experience ‘morning anorexia’. People are not hungry or reluctant to eat in the morning, particularly at breakfast time.²

Preference for high-calorie or comfort foods

The types of food those with night eating disorder tend to eat are high-calorie, high in carbohydrates and sugar, as well as fat. These foods are often comfort foods. Night eating disorder is often associated with periods of stress, and these comfort foods may be consumed in an attempt to feel a sense of reward from eating.² This is likely to be a risk factor for obesity and diabetes.³

Emotional and psychological symptoms

Night eating disorder tends to occur alongside emotional and psychological symptoms, such as depression and anxiety. These feelings may be a driving force in late-night eating. For example, people may eat as a way to cope with their feelings and with the stress they are experiencing. 

On the other hand, night eating disorders may cause feelings of depression and guilt around eating habits, especially when binge eating and obesity are involved. This can create a cycle of eating disorder symptoms because of the negative emotions, which causes more negative emotions and more overeating.¹ 

People may develop a poor body image and concerns about their appearance when suffering from night eating disorder. Particularly, if they are engaging in binge eating and gaining weight, again leading to more negative emotions. Because of these, behavioural therapies like counselling can help manage night eating disorder symptoms in an attempt to treat the syndrome.¹

Behavioral indicators

Disrupted sleep pattern

People suffering from a night eating disorder may have disrupted sleep patterns in different ways. However, an already disrupted sleeping pattern could also cause night eating disorder. 

Those with a night eating disorder often struggle to fall asleep or stay asleep, which may be the result of hunger or the urge to eat even when not hungry. It could also be due to stresses and negative emotions, and this might drive late-night binge eating and eating through the night. In fact, this syndrome is more commonly found in people with insomnia.¹

On the other hand, eating late at night, particularly high-calorie meals before bed, can increase the time it takes to fall asleep by raising your body temperature and making you feel more restless and unsettled. It can also create bad habits that disrupt your sleeping pattern. You may become conditioned to expect food late at night, which can prevent you from sleeping and increase your food cravings.⁴

Eating in isolation or hiding food

Experiencing guilt and shame around a night eating disorder may lead to people eating in private, hiding how much they are eating from friends and family, and being secretive.¹ This is likely to worsen any feelings of shame and may cause issues with family members, like those in the home.

Physical symptoms

Weight gain 

The exact cause of weight gain in night eating disorders is not completely clear because not everyone will gain weight. Many factors could contribute to weight gain, such as binge eating and consumption of high-calorie foods. However, there may be other factors involved. For example, genetic factors, like genes involved in sleeping patterns and insomnia, might make a person more susceptible to gaining weight when experiencing a night eating disorder.⁵

Gastrointestinal issues

Research has shown that night eating disorder is associated with gastrointestinal and digestive issues, including in the stomach and the food pipe. You may experience symptoms such as bloating and discomfort after eating late at night.⁶ 

One possible explanation is that eating late at night disrupts our circadian rhythm. This is the natural 24-hour rhythm commonly known as our internal body clock. It regulates processes such as sleep, hormones, and metabolism. Eating late at night and having a disturbed sleeping pattern can negatively affect the way our digestive system works, which can involve symptoms such as stomach pain and diarrhoea. The types of food typically consumed may also play a role in these symptoms, as they are typically high in fat. Another factor may be the stress experienced by those with night eating disorder. Stress has been shown to make symptoms worse, including bloating and pain.⁶

Fatigue and low energy

Night eating disorder is associated with disturbed sleeping patterns. This may include getting less sleep or poor quality sleep. Patients will therefore feel tired and have low energy, which will ultimately impact their day-to-day life and activities.¹

Impact on daily life

The potential impacts of night eating disorder on life are extensive, including impacts on social interactions, performance at work and school, and on daily activities. 

Avoidance of social meals due to nighttime eating habits

As people with night eating disorder are likely to experience morning anorexia, they are likely to avoid eating breakfast. This may mean skipping a social meal with family or friends, missing out on a key social interaction that can impair relationships. They may also miss other meals throughout the day if they feel ashamed about their eating habits and if they tend to eat in private. There may be further impacts on social interactions if patients suffer from depression and anxiety because they may prefer to spend more time alone and may not feel able to interact with people around them.²

Difficulty concentrating or low energy during the day due to poor sleep

Due to difficulties sleeping, patients might experience trouble concentrating and might have low energy throughout the day, because sleep is crucial for our brain to work properly. These symptoms can significantly impact a person's quality of life.² 

• It can be much harder to complete tasks such as cooking and cleaning when you have low energy, and this can be detrimental to your mental health. 
• When it comes to work and school, it can be more difficult to focus and take in information, as well as complete any work-related tasks. This, therefore, affects performance and can jeopardise a person's position. 

Treatment

It is important to seek help if you are struggling with any symptoms of night eating disorder. You can turn to medical professionals such as your GP for a potential diagnosis and for support with your symptoms. There are treatment options available.

Some antidepressants have been found to reduce night eating, and they potentially have the double effect of managing symptoms of depression and anxiety. Another potential option, which has limited research, is taking melatonin. This is a hormone that helps regulate the timing of when you fall asleep and wake up. While research is controversial, melatonin tends to have a low side effect profile, so those with night eating disorder could consider trialling supplementary melatonin after consulting their physician.⁷

Therapy can be a treatment option for night eating disorder. This would include challenging beliefs, such as the belief that you cannot sleep without eating. It may also involve establishing both a support network of friends and family and good sleep hygiene. Sleep hygiene refers to creating an environment that promotes good sleep, such as establishing a consistent bedtime. There have been some promising results from therapy, but more research is needed into the risk factors in night eating disorder and the treatment options.⁷

Summary

Night Eating Syndrome (NES) is an eating disorder marked by consuming large amounts of food in the evening or after waking during the night. Key symptoms include morning anorexia, nighttime eating urges, insomnia, low evening mood, and the belief that eating is needed to fall asleep. It often begins in late teens to twenties and can lead to emotional distress, weight gain, and disrupted sleep.

Typical behaviours include binge eating at night, preferring high-calorie comfort foods, eating in isolation, and experiencing disrupted sleep. NES is often linked to depression, anxiety, low energy, and digestive issues, and it can negatively impact daily life, relationships, and work or school performance.

Treatment options include therapy, antidepressants, and possibly melatonin to regulate sleep. Seeking medical help is essential for diagnosis and support.